Internal jugular vein valve incompetence in COPD and primary pulmonary hypertension
Article first published online: 11 MAR 2008
Copyright © 2008 Wiley Periodicals, Inc.
Journal of Clinical Ultrasound
Volume 36, Issue 8, pages 480–484, October 2008
How to Cite
Doepp, F., Bähr, D., John, M., Hoernig, S., Valdueza, J. M. and Schreiber, S. J. (2008), Internal jugular vein valve incompetence in COPD and primary pulmonary hypertension. J. Clin. Ultrasound, 36: 480–484. doi: 10.1002/jcu.20470
- Issue published online: 3 SEP 2008
- Article first published online: 11 MAR 2008
- Manuscript Accepted: 27 DEC 2007
- Manuscript Received: 13 JUL 2007
- internal jugular vein;
- valve incompetence;
- duplex ultrasonography;
Under physiologic conditions, intact internal jugular vein valves (IJVVs) efficiently prevent retrograde venous flow during intrathoracic pressure increase. Chronically elevated central venous pressure found in patients with chronic obstructive pulmonary disease (COPD) and primary pulmonary hypertension (PPH) might lead to IJVV incompetence (IJVVI). The aim of this study was to analyze the prevalence of IJVVI in patients with COPD and PPH using duplex sonography (DUS).
We included 30 COPD patients, 5 PPH patients, and 100 healthy controls in the study. IJVVI was diagnosed if retrograde jugular blood flow was seen on DUS during a Valsalva maneuver. Retrograde venous flow intensity was evaluated and graded according to extent and duration of reflux.
IJVVI was found in 18 (60%) COPD patients and in all 5 (100%) PPH patients, which was significantly different from the controls (27%; p < 0.005). The intensity of venous retrograde flow correlated with the pulmonary artery pressure.
Compared with healthy controls, COPDand PPH patients demonstrated a significantlygreater prevalence of IJVVI, which seems to be caused by the elevated central venous pressure. These patients may be at higher risk to develop central nervous system diseases related to cerebral outflow obstruction. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.